Office of the Dean of Student Life

Information & Resources

Student Life Quicklinks

OSU Home » Dean of Students » OSU Bias Incident Report Form

Reporting Bias Incidents at OSU

The Bias Response Team (BRT) affirms the Oregon State University missions statement and is committed to contributing to a campus community that fosters intellectual curiosity, academic freedom, diversity, and personal empowerment. The OSU Campus environment celebrates knowledge, world views, learning styles and values; and engenders personal and societal values that benefit the individual and society. Toward that end, the BRT celebrates the Oregon State core values of accountability, diversity, respect, responsibility, and truth.

It is incumbent upon the Bias Response Team to lead bias incident responses responsibly and professionally. The Team is committed to preventing further acts of bias by educating the OSU community about the effects and root causes of bias incidents. Reports of cases brought to the BRT will occur with consideration of the parties around confidentiality. There may be cases where the health and safety of other members of the community will need to take precedence over the individual's preferences. The decision about the level of information disclosed in these situations will be guided by FERPA and other applicable laws as well as sensitivity to the well being of the individual(s) involved and the greater community. The BRT will compile and make available reports of its activities and reported incidents.

If you provide contact information then a member of the BRT will contact you to follow-up and provide resource information, make appropriate referrals, and provide other assistance.

If the reported incident involves physical harm to you or others, please file a police report.

On-campus incidents - report to Department of Public Safety/Oregon State Police (541)737-3010

Off-campus incidents - report to Corvallis Police Department (541)766-6429

Immediate/urgently needed assistance - call 911

OSU Bias Incident Report Form

This report will be reviewed by the Oregon State University Bias Response Team (BRT) to determine appropriate action and referral. Thank you for taking the time to submit this report.

If you prefer to report by phone, please call 737-SAFE.

1. Date/time/location of incident - please be specific:

2. The person completing this form is the (check all that apply):
Target of behavior
Witness
Family member
Friend of the target
Partner/Spouse
I viewed the result of the behavior (saw grafitti, vandalism, etc.
Other (please specify):

3. Please provide a narrative of the incident:

4. Person reporting: You may choose to remain anonymous. However, if you would like to have the Bias Response Team help you explore options, look at alternative ways to deal with and resolve the situation, or advocate on your behalf, please complete this section - Name, Address, Phone, Email - indicating which is the best way to reach you.

5. To your knowledge, was this incident reported to a law enforcement agency?
Check the box for "yes" If yes, please specify agency:

6. Was this incident reported to any campus agency or department (other than to BRT through this form)?
YesNo Please explain:

7. Type of bias activity:
Damage to property
Graffiti/Signs
"Outing" or threat of "outing"
Threatening mail/email
Threatening voice mail/message
Telephone harassment
Physical assault/Confrontation
Stalking
Verbal harassment/Slurs/Threats
Written slur
Other (Please specify "other" below):

8. Is there an indication of involvement of an organized "hate" group in this incident?
Yes
No
Maybe

9. Who or what was target of this incident?
Academic area/building
Administrative area
Athletic facility
Cooperative House
Cultural Center/Pride Center
Dixon Recreation Center
Greek Chapter
Library
Memorial Union
Off campus but in Corvallis/Corvallis area
Off campus faculty/staff residence
Off campus student residence
Orchard Court Family Housing
Person/s
Residence Hall
Other - please specify:

10. Please provide us with specific information about where this incident took place and describe/detail in text box:
Academic department
Classroom
Local bar/pub/restaurant
Greek living group
Off campus apartment/house
On campus apartment
On campus living group
Work department
Other campus location (describe below)
Other (describe below)

11. Were there any witnesses to the incident? If so, please provide name/s and contact information (if known):

Office of the Dean of Student Life

Information & Resources

Student Life Quicklinks

Reporting Bias Incidents at OSU

OSU Bias Incident Report Form

This report will be reviewed by the Oregon State University Bias Response Team (BRT) to determine appropriate action and referral. Thank you for taking the time to submit this report.

If you prefer to report by phone, please call 737-SAFE.

Your report will be reviewed by a member of the Bias Response Team (BRT)

If you have questions about this report, please contact the Office of the Dean of Student Life (541)737-8748

Office of the Dean of Student Life

Information & Resources

Student Life Quicklinks

Reporting Bias Incidents at OSU

OSU Bias Incident Report Form

This report will be reviewed by the Oregon State University Bias Response Team (BRT) to determine appropriate action and referral. Thank you for taking the time to submit this report. If you prefer to report by phone, please call 737-SAFE.

Your report will be reviewed by a member of the Bias Response Team (BRT)

If you have questions about this report, please contact the Office of the Dean of Student Life (541)737-8748

This report will be reviewed by the Oregon State University Bias Response Team (BRT) to determine appropriate action and referral. Thank you for taking the time to submit this report.

If you prefer to report by phone, please call 737-SAFE.